Mouth care plans, dental access and escalation

NICE recommends assessing mouth care needs on admission, recording them in the personal care plan and reviewing the plan when needs change. The quality standard says staff should record the resident's dentist details, whether they wear dentures, and the level of support required for daily mouth care.

NICE also advises care home policies to include information on local dental services, emergency or out-of-hours dental care, and community dental services. Care staff therefore need to know the resident's dentist, the routine support planned, and how to access help when mouth problems become urgent.

What a useful mouth care plan should cover

• Daily routine: teeth, dentures, products used and level of help needed.
• Dental access: dentist details, last contact and what to do if there is no dentist.
• Denture details: whether dentures are worn, where they are stored and whether they are marked.
• Current concerns: pain, ulcers, dry mouth, swelling, bleeding or changing intake.
• Escalation: who to tell and how to access routine or urgent dental support.

NICE states that only practitioners registered with the General Dental Council and working within their scope may diagnose and treat dental disease. Frontline care staff should recognise, record and report concerns clearly, but must not attempt to diagnose dental conditions.

Manager focus: champions and local links

Mouth care plans only improve care if staff can find them, follow them and update them when the resident's needs change.